Internal And External Factors Of Role Stress

For the majority of nurses working within the field of modern medicine, one of the most difficult tasks associated with the job must be maintaining the tenuous balance between the pull of professional ambition and honoring the responsibility owed to their current role. Nursing remains one of the most stratified occupations in terms of recognized qualification, and a wide disparity exists between the positions of Licensed Practical Nurse (LPN) and Registered Nurse (RN) in terms of both experience and education. While standards vary from state to state, individual LPNs may be required to complete many of the same duties as their RN counterparts, including the administration of intravenous fluids, the withdrawal of blood for testing, and other crucial aspects of inpatient care. Despite the similar set of skills possessed by LPNs and RNs, the latter position commands a greater level of prestige and a significantly higher salary within the nursing field, and because of this many qualified LPN's aspire to attain the rank of RN in order to better their personal and professional lives. As a working LPN beginning the transition to future RN career, I have encountered many difficulties and obstacles which I feel will only strengthen my resolve and crystallize my ambitions. During the extensive reading required to gain the knowledge needed to work as an RN, a statement made by the authors of LPN to RN Transitions: Achieving Success In Your New Role resonated deeply with me, and I

Everyday nurses are learning something new. There is constant change as nurses face new challenges and advance their career. There are two models of transition that consider these challenges associated with change (Blais & Hayes, 2016). Bridges model of transition consists of three phases and he believes we go through all three as we experience change (Blais & Hayes, 2016). The first stage is the ending phase, which involves letting go of the past and discontinuing a connection (Blais & Hayes, 2016). When I got accepted into the nursing school I transitioned from a regular college student to a nursing student, which meant strictly focusing on passing nursing school. Once I pass the national state exam, I transition to a Registered Nurse. Then I transitioned from my employment setting as a waitress to a medical surgical telemetry nurse in a hospital setting. Within the ending phase, Bridges also describes four components: the second phase is the ending phase. It has four sections: disengagement, disidentification, disenchantment, disorientation. I fall under disenchantment, I currently work night shift and I have never been a night person. When I first started working night shift I was disoriented to time and constantly felt tired when I was out of work. I have now adapted to the schedule and can balance working nights and not being tired during the days when I am off. The second stage is the neutral zone, which consist of accepting your new role, however, the

Transitioning from an licensed practical nurse to a registered nurse is of the hardest things I have ever done. Twelve years ago I took my boards and became a licensed practical nurse. Going to school to become an LPN was difficult, but I was not a mother and I did not work full time as I do now. Getting to know the students I attend school with has made me realize that each student’s role transition is different, with unique outlooks and emotional roller coasters. In the following paragraphs I will preview licensed practical nurse to registered nurse role comparisons, my change in

When most experienced registered nurses hear the word shock, they begin to use their critical thinking skills to determine the patient’s immediate need. However, new graduate nurses in the career field are faced with a different type of shock; they are faced with transitional shock. Transitional shock is a theory created by Judy Duchscher. Her theory is based on reality shock which is a term coined by Marlene Kramer. Reality shock is when new nurses recognize clinical practice and the classroom setting are two different worlds (Hentz and Gilmore, 2011, p.134). When new graduates transition to a registered nurse position, it does not happen with ease. Over the years, there has been a rise in concern with this transition. As new graduates move in the career field, they may feel anxious and uncertain about their new responsibilities. Unfortunately, when there is a high demand of nurses, new graduate nurses are expected to begin a new job at full speed, but they are not able to handle the fast pace position they are placed in. When new graduates are expected to accomplish task they are unprepared for, it sets them up for transitional shock. To minimize transition shock for new graduates, finding a mentor, preceptor, seeking an internship or residency program may help ease the transition.

What was your experience of transition into practice from the role of a student to that of a RN and what advice does you have?

This has allowed me to experience what each person’s role in a hospital setting truly is. Both physician assistants and nurse practitioners share a lot of the same responsibilities as a physician, although nurse practitioners are given the flexibility of choosing which specialty they are interested in pursuing. This autonomy is what drew me into this position, which includes a lot of independence within the practice. Over the years that I have worked in healthcare, I have realized that patients need a health care provider who will be an advocate for them, and they also need someone who will truly listen to them in order to help improve their quality of health. The roles and job responsibilities of a nurse practitioner have caught my attention and therefore have made me want to pursue this career

The new graduate nurses (NGN) are faced with various issues and challenges especially in their first year of nursing practice. The period of transition from a student to a graduate nurse is a demanding period that is filled with new experiences and there are several concerns and factors that can affect the transition process. The research into the issues has recommended some strategies that can be utilised to ease the transition process from being a student to a professional practicing nurse. Exhaustion, reality shock and time management are some of the factors and issues that the new graduate might encounter during their first year in their career.

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

The profession of nursing is usually described as high-demand job, as well as stressful. The American Association of Critical-Care Nurses believes that nurses can empower their work environments and truly make a difference (AACN, 2016). Although nurses have the ability to join committees and help make changes slowly, there are many factors in the nursing that cannot be changed by nurses. “The global increase in the aged population, the intensity of health care problems, the incidence of chronic illnesses and advanced technology, nurses are faced with a variety of work-related stressors” (Lambert & Lambert, 2008, p. 38). Regardless of nursing communication and social aspects of units, nurses need to accept some stressors as they are and

Nursing can be a demanding career, but the benefits far much outweigh the challenges. Most importantly, it’s the rewards it offers by allowing an opportunity to make a difference in another person’s life through the provision of care when they need it. Just as Patricia Benner theorized in her book “Novice to Expert,” nursing encompasses both educational knowledge and extensive clinical experience acquired throughout one’s career. This far, I continue to acquire knowledge and clinical knowhow which will promote proper and efficient care to patients. Since I began practicing one year ago in a long-term healthcare facility, I have interacted with patients, families, physicians and other members of the healthcare team to coordinate patient’s care which has enabled me to gain confidence in myself. While I cannot deny that it was difficult to transition from a student to a licensed nurse, I learnt to overcome these challenges and focus on my strengths. Practicing as an LPN has provided a platform to learn and gain experience even though the duties and responsibilities are limited by the scope of practice.

The success of NPs depends on practicing evidence-based care with competency in assessment, diagnosing, managing patients, and maintaining a caring practice. The nursing component of the NP role continues to be challenged from within nursing, as well as by large national physician organizations. NPs are extensions of nursing practice who are guided by nursing theory. The transformation from nurse to the advanced practice role of NP involves development of advanced knowledge and skills for listening, knowing, being with patients, connecting patients to their communities, promoting health,

For years now it has been well know and documented that there is a brutal disconnect between what school prepares NGRN for and the reality they find once they begin working.(Duchscher, 2009) This stark difference found between school and reality sets new graduates (NG) up for a hard fall and the disillusionment they are under when entering the professional practice can lead them to exit nursing altogether.(Duchscher, 2009) The problem then of course becomes recruitment and retention, and the cost of training new nurses back in 2007 was recorded to be as much as 82,000 to 88,000 each.(Ulrich et al., 2010)

I had the pleasure of interviewing Javita Fizer MSN, RN, FNP-BC. She 's currently employed at a federally qualified health center (FQHC). According to J.F. she practiced as a registered nurse (RN) for ten years before becoming an advance practice registered nurse (APRN). She has been a APRN since 2014 and has worked in inpatient and acute care settings. Recently she began working in a primary care setting and made it clear that this is her comfort zone. J.F. has been practicing as a APRN for two years and she places herself as a novice in her role. When asked about the single-most important factor in successfully transitioning from expert staff nurse to beginning level APRN, J.F. mentioned clinical experience and knowing limitations. She

As a nurse administrator, I have a distinct role to play in the healthcare sector. Preparation for this position commences at the graduate level; either masters or doctoral level. Prospective students at graduate level are expected to indicate a variety of roles across healthcare sector as stipulated in the legislative law. Factors such as the nature of the organization and its system of leadership provide credible knowledge that is critical for nursing management roles. As opposed to Gerontology Nurse Practitioners who are expected to have a wide array of technical and hands-on skills

In a frequently cited study, Kelly and Mathews (2001) described the themes of loss of control of privacy and time, relationship changes, isolation and uncertainty in a new NP role. The authors identified the most successful coping strategy was the development of a support network and a mentor to aid in role development. The study was rated a Level 3 due to its qualitative nature. It was given a quality rating of B as, out of a convenience sample of 30 new graduate NPs, 21 participated and consistent themes